[unreadable] This study will address the question of why physicians who are familiar with the appropriate clinical practice guideline nevertheless do not routinely offer effective, evidence based interventions for tobacco addiction to their patients. The study will employ a diagnostic model in continuing medical education (CME) program development described in Olson, Cochrane & Mejicano (2004). The model is designed to examine clinical decision making in an organizational, economic, social and political context and results in a concept map illustrating the multiple factors influencing physicians' behavior in the area of clinical interventions and the complex interrelationships between those factors. This study will examine physicians' experiences with obstacles and challenges to integrating evidence based practice in the area of tobacco addiction into their practices, outline the relationships between the obstacles identified, and identify how the results of this study give guidance to interventions aimed at change in clinical practice in the area of tobacco addiction. The study will use a qualitative phenomenological research design with in-depth interviews of past participants in CME training activities designed to teach tobacco intervention guidelines. [unreadable] [unreadable] [unreadable] [unreadable] [unreadable]